1283 Calahaln Rd (2)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
To., of Bedrooms Date
. his permit is granted to for the installation of a s�e tank..
at -the residence of _ Address
Building Contractor s-�j� _ Address
Septic Tank Specifications: / Length Width Depth Capacity _Gal. "DO
.Manufacturer's Name 2,u4���-% 6� � Address ^ __
I1c, of li:ies_ c,7, width_YV- in. Total Length r dx,�r - ft. Eo. of Sq. Ft. op
True of filter material %-ryC-�' Total tons used j
M-inimua kequirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 600
Three-bedroom house 900 900
No one shall install a septic tank in Davie County without a permit from the Health Officer
or his agent.
Date of final approval Signed.
Sanitarian
T hereby certify that the above septic tank has been installed according to specifications.
Signed:
Septic Tank Contractor
Note- Make sketr;.: of disposal system on back of sheet and mail to Health Center, Mocksville.